Stereotactic Radiosurgery (SRS) in the Management of Drug Resistant Non Neoplastic Epileptic Seizure; A Case Report and Review of Literature

Apart from neoplastic lesions there are many non-neoplastic pathological lesions which causes epileptic seizures. Surgical resection is primary treatment for such seizures. Stereotactic Radiosurgery (SRS) is an alternative choice for lesion located deep in brain and eloquent area. We present a case of 18 year old boy who presented with drug resistant epileptic seizure patient. He had received various antiepileptic drugs (AEDs) over the years, all of which were only partially effective in maintaining freedom from GTCS. His symptoms subsequently became totally refractory to AED. MRI brain revealed a gliotic lesion in the right occipital area near optic radiation. Subsequently, in view of ineffectiveness of AEDs in preventing seizures, he was offered definitive treatment, given the risk of progression to epileptic encephalopathy. Since the patient desired to undergo a non-surgical approach for treatment, he was offered SRS. He received SRS with 27 Gy in 3 fractions over 6 days. After one year of follow up, he is now having only occasional seizures associated with anger and fever.